Is the public option a “slippery slope” to single-payer?

It was hot last night at Seattle’s Town Hall, both literally and figuratively. Outside, advocates of a single-payer healthcare system were chanting and leafleting. Inside, as Gov. Howard Dean spoke about healthcare reform, the crowd was only slightly less boisterous.

Though friendly and receptive as Gov. Dean took the podium, when it came time to take questions from the audience it quickly became apparent that the many of those inside shared the sentiments of those on the street, with some of the questioners filibustering their opportunity at the mic to take an uncompromising stance in favor of single-payer, and opposed to anything less. It was apparently a familiar scene for Gov. Dean, who had just arrived from a similar engagement in Portland, OR, where several single-payer advocates had to be removed from the audience after disrupting the proceedings.

Gov. Dean, a licensed physician and former presidential candidate and DNC Chair, is on tour promoting his new book “Prescription for Real Healthcare Reform,” but for many true believers, Gov. Dean’s prescription—take a public option and call me in a decade—isn’t real enough. What plays out is the sorta classic confrontation between idealism and pragmatism that so often undermines reforms coming from either end of the ideological spectrum, leaving those in the mushy middle so firmly in control. And it’s the kinda confrontation that the insurance industry and big pharma are counting on to stave off reform for another generation.

As Gov. Dean repeated throughout the Q&A, he’d personally prefer a single-payer system, as it’s the only reform that can guarantee universal coverage while quickly providing the level of savings needed to get our healthcare costs under control. But as he also repeated, polling consistently shows that the general public just isn’t there yet, let alone the laggards in Congress, so while single-payer shouldn’t necessarily be taken off the table, it would be unrealistic to expect it to move any further… at this point in time.

And here’s where that confrontation between idealism and pragmatism really comes into play. Public option opponents on the left dismiss the proposal as mere half-measures, while public option opponents on the right attack it as a slippery slope to single-payer. And they’re both right. The question is, will the lack of enthusiasm for the public option from idealists on the left ultimately play into the hands of the pragmatists on the right in their efforts to scuttle any substantive reforms at all?

As I’ve argued before, the public option is a slippery slope to single-payer, if implemented and executed correctly. Now some might characterize this admission as cynical and dishonest, but good policy done right is inherently a slippery slope toward better policy. As it should be. And it’s a slope we slide down only with the approval of a majority of voters.

So after he finished signing books I asked Gov. Dean whether he believed the public option would be a slippery slope to single-payer. I wanted him to say yes, and I sensed that he wanted to say yes as well. But he’s too smart for that… and too pragmatic. Instead, he enunciated what I think is the most rhetorically effective response I’ve ever heard to the right’s slippery slope argument, a response that totally undermines their objection, even without denying it:

[audio:http://horsesass.org/wp-content/uploads/dean.mp3]

This will be the change that the American people want at the pace that they want it. So the opponents have no right to make that argument. The Republican ability to make that argument assumes that they know better than the American people, that they’re so smart that the American people have no right to make up their own mind.

That’s what this bill is about. This bill is not about whether to have a single-payer or a public option or a private system; this bill is about whether the American people get to choose for themselves, or whether congressmen take it upon themselves to override the will of the American people and do something different. It’s a straight up vote between whether you’re in favor of the health insurance industry, or whether you’re in favor of your constituency. Everybody’s going to have to make that vote, and we’ll be watching.

The same could be said to the uncompromising advocates of a single-payer system.

I may not live to see the bottom, but I still believe that the public option will ultimately set us down that slippery slope to single-payer, and my sense is that many of its proponents believe the same, whether for pragmatic reasons, they’re willing to publicly say so or not. If given the choice, many Americans will flock to the public option, and if private insurers simply aren’t able to compete, I’m alright with that. It is ironic, after all, that those who insist there is no fundamental right to basic health care, also tend to be those who insist that there is a fundamental right to selling private health insurance.

Of course, there isn’t. And if the single-payer advocates can be as patient as they are passionate, I’m confident the American people will ultimately prove them right.

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Slippery slope scenarios are at the heart of many wingnut arguments. Remember the “domino theory”? How’d that work out? Sometimes the slope is indeed sticky, and the pressure for national health should be redoubled.

All we hear is 47-48,000,000 uninsured. Fact Check.Org looked at it and it seems the number may be 30,000,000 tops. Fact Check only estimates 6 million illegals. Census estimated through DHS 11.7 million. Here is where Puddy get’s his 12,000,000WikiPedia says 11,000,000. Ya first have to take that number away from 48,000,000 and you get 37,000,000. Next how many choose not to get insurance. Then you have 12,000,000 per FactCheck who are eligible for Medicaid which already exists. So 37,000,000 – 12,000,000 is 25,000,000. Then you take away those who choose not to purchase it but can. Let’s say 5,000,000

Well lookee here. A former insurance executive makes a little trip to a health care “fair” at a county fairgrounds.

I borrowed my dad’s car and drove up 50 miles up the road to Wise, Virginia. It was being held at a Wise County Fairground. I took my camera. I took some pictures. It was a very cloudy, misty day, it was raining that day, and I walked through the fairground gates. And I didn’t know what to expect. I just assumed that it would be, you know, like a health– booths set up and people just getting their blood pressure checked and things like that.

But what I saw were doctors who were set up to provide care in animal stalls. Or they’d erected tents, to care for people. I mean, there was no privacy. In some cases– and I’ve got some pictures of people being treated on gurneys, on rain-soaked pavement.

And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee– all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth.

No problem with the status quo – none at all. Nothing to see here. No need to do anything like what the idiot tool @ 3 is implying.

The number of uninsured has been increasing as the economy has hit the skids. Without the pasage of S-chip (that the republicans opposed) the numbers would have been even worse.

The number of Americans without health insurance reported by Families USA is much higher than those reported by the U.S. Census Bureau. According to the census numbers, in 2007 there were 45.7 million uninsured Americans.

The latest estimate over two years is 86.7 million americans.

Families USA says those numbers tell only part of the story. The Census bureau counts only people who were uninsured for the full calendar year. For its own study, Families USA commissioned The Lewin Group to analyze data from the Census Bureau and the Agency for Healthcare Research and Quality. Its study includes people who did not have health insurance for all or for part of the past two years.

Oh and Puddy – show your links, so I can destroy your pathetic try at facts, as usual.

Just like I destroyed you on Global warming – where you cited sources that were wrong or did not support your view – or how Darryl kicked your sorry butt the other day … and showed your “facts” to be full of bombast and holes.

WENDELL POTTER: The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them, that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.

Now this is a former Insurance Executive talking. Describing exactly the PROGRAMMING that has been drilled into right wing tools like the Pooper and the idiot @ 3.

Why is it NutsTooTight can’t figger out stuff? Why is it NutsTooTight needs to be hand held? Why is it NutsTuuTight calls anything other than his “facts” anecdotal stories? Why is it NutsTooTight is a fool? Why is it NutsTooTight just plain stupid?

You know I have a fun idea for the right wing idiots and defenders of the status quo around here.

At the next tea party organize a boycott of Canadian oil and gas. I mean think of it.. All that money is flowing up there to support a health care system that Canadians would supposedly trade in a flat second for OUR “gold-plated” system.

C’mon right wing fools – do a little more walking and turn down the thermostat for the poor suffering people of Canada so they can have OUR health care!

WE live in a screwed up world. Democrats are in fear of the electorate;; somehow they think they can’t inform them of the facts, that our system produces worse outcomes for higher costs — if you’re insured — and disaster if you’re not insured, which most of us turn out to not be even if insured.

Meanwhile there are about 25 nations with some kind of strong single payer system with lower costs and very happy customers.

The excuse that the American people don’t buy it yet is lame, because it’s Democrats job to inform them. You can’t do that by giving in. You can’t do that by implicitly accepting the notion the insurance industry is making an honest, or valuable, profit. They’re not.

You can’t do that if you are afraid to just come out and say the truth:

-denying care to anyone is immoral AND inefficient –the insurance companies and their buddies are lying scum –single payer works nearly everywhere; –yes, there will be rationing, and there already is; but it’s like the rationing we have at the DMV where you wait in line and you can’t jump ahead by paying more; or the rationing in ww2; in other words, it works. And the rationing we have now is (a) you’re not covered unless rich or employed, (b) even when covered you’re not and you can go bankrupt, and (c) you have to fight the insurer every step of the way.

It’s the same deal as with AIG and the financial industry. Profits are built on unabsorbed risk….the whole hting is a scam…it doesn’t work….it’s not a “Free market”…and a governmental control system is proven to work better.

How are are we going to convince Americans to get their minds into single payer under this slippero slope theory anyway?

Is thenotion that by enacting a public option/”compeition” model, the whole thing really won’t work, then the public will realize “holy shit! When those Democrats passed this piece of shit ten years ago, they were really just doing it to get to single payer, now that it doesn’t work, I totally trust them to get to single payer” or will the public think”wow, last time we tried reform the government made a mess of it, I just don’t believ egovernment intervention works in anyway.”

There’s something so fundamentally dishonest about the slippery slope argument I can’t believe it. “Let’s enact something we KNOW won’t work, because it will lead to something that will” is a scam folks.

And be honest. It’s not smart and it’s not strategi — it’s just fucking chickenshit cowardice to have the fight we need to have.

Dammit, France is run by conservatives and their system is waaaaaaay to the left of this public option crap.

Our Democratic party leaders can’t be as left as the conservatives in France, that just is not explainable other than thru cowardice and the most lazy, flabby thinking, like the notion you build up credit with the voters by passing something you don’t really want and that won’t really work.

4. YLB spews: Well lookee here. A former insurance executive makes a little trip to a health care “fair” at a county fairgrounds.

If walmart wasn’t considered an evil corporation by left-wingers I’m sure this would be the start of a trend. Of course, these clinics only help poor people since rich white liberal neighborhoods won’t allow walmart in their neighborhoods.

Please contact the clinic nearest you for more information about their services and fees. Clinic Convenience Here are a few ways clinics save you time and money: No appointment is necessary to visit the clinics Clinics are open seven days a week. View clinic locations and hours. Patient data is electronic, which means limited time spent filling out forms and follow-up visits are quick and convenient All prices are posted clearly, so you always know the cost before treatment An average Get Well visit costs $65 or less. For additional pricing information, contact the clinic nearest you.

No need to for health care “fairs” mentioned above. I guess there must have been a liberal conspiracy that spread the word about the fair so people could drive from three different states to get health care.

Dear Mr. President: I am writing you today because I am outraged at the notion of involving government in healthcare decisions like they do in other countries. I believe healthcare decisions should be between myself and my doctor.

Well, that is not strictly true. I believe healthcare decisions should be between myself, my doctor, and my insurance company, which provides me a list of which doctors I can see, which specialists I can see, and has a strict policy outlining when I can and can’t see those specialists, for what symptoms, and what tests my doctors can or cannot perform for a given set of symptoms. That seems fair, because the insurance company needs to make a profit; they’re not in the business of just keeping people alive for free…

I also believe my healthcare should depend on the form I fill out when I apply for that health insurance, which stipulates that any medical problems I ever had previously in my life won’t be covered by that insurance, and so I am not allowed to seek further care for them, at least not at my insurance company’s expense. That seems fair; otherwise my insurance company might be cheated by me knowing I needed healthcare for something in advance.

And if I didn’t know about an existing condition I had, but I could have known about it, had someone discovered it, I suppose it doesn’t make much sense for my insurance to cover that either.

No need to read it. Since it’s daily kos I know what is says. bush is hitler republicans are evil corporations are evil bush ruined the health system

LIES. Smarmy liar!

Bush is not Hitler. Never needed to be. Being the worst president ever was all he was capable of being.

Republican are evil? Some maybe. Incompetent surely. Corrupt. Many most surely. Out of step with the mainstream of this country? Abso-freaking-lutely! Who won the White House, House, Senate, majority of governorships and state legislatures last Nov? – not the Republicans!

Corporations are evil – not necessarily. They’re set up for one reason – profit. It’s up the rest of us to make sure they don’t profit at the expense of the environment, worker health and safety and don’t exert so much monopoly power that they exact monopoly rents – otherwise they’re welcome to all the money they can make.

Bush ruined the health system – he didn’t care about the health system. All he cared about was power. What was medicare Part D if only a hapless attempt to buy senior votes and/or enrich drug companies.

Translated that means let’s change the system so everyone can have the same healthcare that veterans and native american indians have to suffer with.

More smarmy lies…

Have you ever explained why the health of indians is so piss poor considering they get that free government healthcare.

Have you ever explained why the Canadians, Euros and Japanese are so eager to trade their system for ours?

Ah…such intellectualism. Such thirst for knowledge. Such fairness, Marvin! But I know what wingnut douchebags will say:

we have the greatest healthcare system in the world. Democrats are socialists. We can’t afford it. tort “reform”

So by your reasoning, that makes us even.

And Marvin, Indians have poor health outcomes, not care. The casuality may be complex, you know, something to do with their status, their poverty, etc., but for fuckwads like you, there is no need to actually find out why as long as you can score political points.

“Have you ever explained why the Canadians, Euros and Japanese are so eager to trade their system for ours?”

A mystery wrapped in an enigma. Obviously other western democracies are not really democracies, or they would flock to adopt our incredibly successful system. This can easily be explained if you join the wingnuts and adopt the following believe system:

The earth is only 6,000 years old. On top of that, is flat. The Illuminati or the Masons really run things. The Jewish banker conspiracy REALLY runs things. Israel is the foretelling of Armagedden, and thus the jewish state should be supported to the last drop of American blood. The Tri-lateral Commission runs things. Obama was born in Kenya. Reciting the Pledge of Allegiance will get you into heaven.

22. Proud To Be An Ass spews: And Marvin, Indians have poor health outcomes, not care. The casuality may be complex, you know, something to do with their status, their poverty, etc., but for fuckwads like you, there is no need to actually find out why as long as you can score political points.

Five examples stand out: •The American Indian Health System predates Congress. The United States made its first agreement to provide free health care to Indians in 1787. Spending per capita is roughly $2,000 per year – or about 75 percent of what the government spends per capita on the health of federal prisoners, but the service is the subject of perennial complaints. Indian health officials said last month that they receive about 54 cents for every dollar they need. •President Hoover and Congress created the Veterans Administration in 1930. Over the years, its hospitals have prompted repeated criticism. VA health care costs are expected to rise by 89 percent by 2025, according to the Congressional Budget Office. •In 1965, President Johnson and Congress created Medicare to cover the medical expenses of people 65 and older. “Medicare was supposed to cost $3.1 billion a year. Today, it costs $455 billion a year and is headed for bankruptcy,” wrote Sen. Tom Coburn, R-Okla., a doctor. •Johnson and Congress also created Medicaid, which covers the poor and some disabled people. But despite the fact that its reimbursement rates for services rendered are below those of private insurers, it has become a budget-buster for the 50 states. “Medicaid has shown that access to a govern-ment program is not access to health care. Today, 40 percent of doctors refuse to see Medicaid patients because of a corrupt and broken payment system,” Coburn wrote. •President Clinton and Congress created the State Children’s Health Insurance Program to help families that were ineligible for Medicaid provide health insurance for their children. The program now covers 10 million children and adults. Its costs have risen sharply – from $921 million in 1999 to $10 billion in 2008.

5 programs that haven’t worked out like promised.

Is your family worth the chance this time the federal government does what it says. (that’s a shot at both reps/dems)

Goldy (and Dean) are correct. A pubic option is the ONLY possible choice.

Single payer may be the final result, but the costs of rebuilding our current system into a single payer would be astronomic and the administrative challenges worse than taking on a world war.

The problem is not just the source of money. A single payer system implies uniform services and benefits. Our current system is So divers that implimenting such a sensible goal would be a nightmare.

Look at Seattle. We have at least five different models for support of major health care institutions:

Swedish .. Entrepreneurial, profit making, no research, no public service efforts. Docs are paid fee for service.

King County … Harborview is almost 100% government medicine PLUS a major commitment to trauma, public service, and research. Docs are paid salaries. Major residency program and medical school.

UW … UW medicine mixes private and government medicine PLUS a major commitment to public service, and world class research. Provides regional expertise i9n many areas, national in others. Docs are paid salaries with health care subsidized from UW research budgets. Major residency program and medical school.

UW Hutch/Cancer Care Alliance Mush like UW Medicine but provide a unique resource for transplantation and cancer for the world.

Childrens In some ways like Swedish but HUGELY successful. Essentially Children is the pedsiatric hospital for an area stretching from the North Slope to Utah. Docs mix salary model with fee for service.

VA Single payer, Government medicine for a selected communioty of aging males. Docs all salaried.

Group Health The only true HMO model in the city, emphasis on preventative medicine, extensive use of PAs, docs on salary.

Other areas of the country add more diversity, esp. care for profit centers, religious hospitals, concierge medici9ne (starting in Seattle now), ….

Of course I am leaving out all the for profit “centers” for Lasix, Optometrists, Natural medicine, health scans, etc.

All of this comes BEFORE the bizarrely different standard of the different entities that pay for services. Healthcare benefits in our current system range all over the spectrum. Does your policy cover naturopathy? chiropractic? diabetes counseling?, transplants????

The virtue of a a public option is that it provides a benhchmark that can be used to rationalize this mess. For example the oubloic option, like Medicare, is likley to cover so many people that all of the above entities will need to choose to accept its fees. This could mean,m for example, that vets will be able to chopose whether to be served at VA or Swedish. If Swedish were to refuse this it could become uncompetitive. In contrast, Group Health has been dieing a slow death under our current system.It is not hard to imagine GH being a very good vendor for Goverment Medicine.

There are many other examples. Currently the UW and King Co (plus Childrens) bear most of the burden of resident and medical school training. It might make sense for vendors seeking GovMed fees to be required to be involved i residency and med programs ass is common in other countries.

Employers would also be affected hugely. Imagine a union negotiation needing to choose between Beoing funding healthcare or just paying for GovMed. If GivMed is good, I would expect Unions to choose other benefits and get this healthcare albatross off of the Corporate neck.

Bottom line, GovMed as an option is a tool. We are going to get thuis tool simply because there is no other viable option. BUT .. there are many issues in howe this option will work:

1. Will GovMed be subsidized, as Medicare is now, by an indirect taxon other plans?

2. Will GovMed be comprehensive. OPlans elsewhere .. England and even Oregon are not.

3. Will GovMed cover fee for service and capiattion models. Massachusetts looks like ti si dropping fee for service.

We have the 37th worst quality of healthcare in the developed world. Conservative estimates are that over 120,000 of you dies each year in America from treatable illness that people in other developed countries don’t die from. Rich, middle class, and poor a like. Insured and uninsured. Men, women, children, and babies. This is what being 37th in quality of healthcare means.

I know that many of you are angry and frustrated that REPUBLICANS! In congress are dragging their feet and trying to block TRUE healthcare reform. What republicans want is just a taxpayer bailout of the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry, and the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry. A trillion dollar taxpayer funded private health insurance bailout is all you really get without a robust government-run public option available on day one.

YOU CANT HAVE AN INSURANCE MANDATE WITHOUT A ROBUST PUBLIC OPTION. MANDATEING PRIVATE FOR PROFIT HEALTH INSURANCE AS YOUR ONLY CHOICE WOULD BE UNETHICAL, CORRUPT, AND MORALLY REPUGNANT. AND PROBABLY UNCONSTITUTIONAL AS WELL.

These industries have been slaughtering you and your loved ones like cattle for decades for profit. Including members of congress and their families. These REPUBLICANS are FOOLS!

Republicans and their traitorous allies have been trying to make it look like it’s President Obama’s fault for the delays, and foot dragging. But I think you all know better than that. President Obama inherited one of the worst government catastrophes in American history from these REPUBLICANS! And President Obama has done a brilliant job of turning things around, and working his heart out for all of us.

But Republicans think you are just a bunch of stupid, idiot, cash cows with short memories. Just like they did under the Bush administration when they helped Bush and Cheney rape America and the rest of the World.

But you don’t have to put up with that. And this is what you can do. The Republicans below will be up for reelection on November 2, 2010. Just a little over 13 months from now. And many of you will be able to vote early. So pick some names and tell their voters that their representatives (by name) are obstructing TRUE healthcare reform. And are sellouts to the insurance and medical lobbyist.

Ask them to contact their representatives and tell them that they are going to work to throw them out of office on November 2, 2010, if not before by impeachment, or recall elections. Doing this will give you something more to do to make things better in America. And it will help you feel better too.

There are many resources on the internet that can help you find people to call and contact. For example, many social networking sites can be searched by state, city, or University. Be inventive and creative. I can think of many ways to do this. But be nice. These are your neighbors. And most will want to help.

I know there are a few democrats that have been trying to obstruct TRUE healthcare reform too. But the main problem is the Bush Republicans. Removing them is the best thing tactically to do. On the other hand. If you can easily replace a democrat obstructionist with a supportive democrat, DO IT!

You have been AMAZING!!! my people. Don’t loose heart. You knew it wasn’t going to be easy saving the World. :-)

Puddy has said the system needs modification. Look at all the Puddyisms you’ve collected in your “search” fool. Puddy has also said “the messiah’s” proposed system ain’t the fix. Just cuz yous unemployed and wanna git sumtin for free ain’t gonna be paid by Puddy and others fool!

Gee Stupes I think the family and I will make a point of having a picnic at a Park in Everett. Imagine that – my family enjoying an Everett recreation facility on your property tax dime.

Or maybe we’ll just spend some time at St Edwards Park (it’s closer to home) and think of you as we recreate on your sales tax dime. Or just think of all the goods and services you buy in this state whose B&O taxes are passed on to you that go to pay “librul” teachers salaries in Seattle who then teach my kids to make only MORE little “libruls”.

I’ll bet that state of things really burns your silly ass!

If some right wing idiot asks us if we’re residents of Everett. I’ll say shit no we’re here on Stupes’ dumbass selfish dime!

Be a tax protester or some stupid shit – take it up at the next feckless tea party – you know the one where your compassionate conservative crowd will boycott Canadian oil and gas to starve money from that evil Marxist socialist health care system they have up there.

I means Stupes it’s a great idea. According to idiots like you Canada will trade their system for ours in heartbeat – with your modifications of course.

I mean think of it Stupes – everytime you park your ass in your SUV for a spin to the right wing meetup or turn up the thermostat you are FUNDING SOCIALISM in CANADA… ‘ How can you live with that???

37 – I go incognito when wandering where unhinged right wing fools dwell – for mine and my family’s protection.

When a fool like you starts dribbling about what he heard on Rush I’ll just nod and say yeah I hear that guy once in a while on the radio – he’s a funny kind of drug addict isn’t he?

When you dribble about Sean’s Insanity I say yeah he’s so funny but kind of depressed since Obama won.

And then you dribble about the “messiah”? Uh you mean Jesus? Never been much of a church goer but I agree that religion CAN be a positive addition to one’s life…

Then my wife who is ever the astute observer of right wing idiocy will step in and say, we gotta go husband. Then I says nice talking to you. Have a nice day! Keep on listenin’ to that Limpblow.. uh Rush!

Roger Rabbit has returned from his lettuce-finding … er, fact-finding … expedition and will resume putting wingnuts in their place, which is in a toilet bowl with the lid shut and pushing on the flusher handle.

I am far more concerned about the huge cost of healthcare than I am about the quality of care here.

We have the 37th worst quality of healthcare in the developed world.

These numbers are really not very informative for several reasons, including the huge effect nutrition, vaccination, welfare, drugs, the car culture, have on children in this country.

In part we pay more because we subsidize R&D used around the world. Almost every major new technology and drug in my life time has been commercialized in the USA.

The other cost issue is that we pay for things in nutty ways. We use ERs @ $1000/hrf where other countries offer walk in clinics at night and weekends. We may have the best ERs in the world but treating an ear ache with an F22 makes littl4e sense. We offer “free” care to the indigent but hide the costs of that care in our insurance bills. We incentivize physicians to do procedures rather than care for patients after putting them into hundreds of thousands of dollars of debt to become physicians.

Our family structures no longer provide for care givers for the elderly.

Finally we have developed a myth that “preventative medicine” will save money. That is utterly wrong, at least for adults. We all get sick and die. The total care we need to get to that point is increased by extending life. The equation is an easy, if scary one:

MORE OLD FOLKS = MORE COSTLY MEDICINE

A GovMed option is essential simply because we need a tool to reshape this messed up system. With GovMed in place many sensible things can be done:

1. Offer scholarships in return for physicians entering a national health service.

2. GovMed can be limited to providers willing to accept capitation (pay per patient rather than per procedure). This would limit choice to providers willing to be paid in this way, but private companies would be free to fund those who want to use higher priced docs to do their breast enlargments.

3. GovMed can increase expenditures on development of drugs that save money as opposed to drugs that optimize the bottom line. There are classes of pharmaceuticals NOT being developed today because their is no economic model for their development.

4. Rather than the US subsidizing Canada and Europe, we could develop common research targets as in 3 that would benefit everyone. Imagine European/Chinese/American drug firms competing to develop the best and cheapest generics! BTW, cheap labor is largely useless in drug manufacturing. Drug manufacturing is largely a matgter of high tech. Why shouldn’t the US be THE place to make cheap drugs?

The coolest thing about GovMed, as opposed to a single payer system, is that the insurance companies would be free to compete ON PRICE and SERVICES. I suspect many would pay an additional fee for being able, as one example, to have their lung cancer treated by prayer or by the surgeon who looks like Brad Pitt or even to be able to have an elective procedure (eg nose jobs) done sooner. Nothing wrong with capitalism IF there is competition.

@43: While I agree with some of what SJ says, Seattle Jew wrote this truly stupid thing:

Finally we have developed a myth that “preventative medicine” will save money. That is utterly wrong, at least for adults. We all get sick and die. The total care we need to get to that point is increased by extending life.

Hey, every single study says that preventative medicine saves money….do you not pay attention?

Which is more cost effective: vaccinations or disease?

good diet and exercise plan or years on diabetes/heart/blood pressure meds?

preventative screeenings for cancer or late term treatments for a cancer that could have been surgically removed but is now metastatic and requires expensive hospitalization?

Pap smear or ovarian cancer?

yes, we all will get older and die – but there is a big difference in care costs (Alzheimer’s alone can be delayed and prevented by good nutrition and exercise).

Prevention works – period.

It saves money and allows people to remain healthy in mind and body for longer periods.

Our health care system should be based on prevention and encouraging healthy lifestyles. Most of the processed food we eat and the lack of exercise this society gets is just plain poison and a prescription for chronic disease.

According to factcheck.org – a link Puddy still did not give, I got this:

The Census Bureau estimates that 45.7 million lacked health insurance at any given time in 2007. But fewer lacked coverage for the full year, and more did without for one or more months during the year. All three numbers are likely to be higher for 2008 due to massive job losses.

oops – Puddy is once again wrong, false and full of it.

Gee, am I suprised?

30 million…..the lowest possible estimate for over two years ago counting only those who did not have insurnace for the entire year.

I think you should push for a boycott of Canadian oil and gas at the next “tea party” you attend. A compassionate conservative like yourself should not send money to a country where its used to fund such an evil “marxist” health care system (in your puny mind). Think of it – every time you hop in your car you’re funding socialism. We import more oil and gas from Canada than from any other country.

good diet and exercise plan or years on diabetes/heart/blood pressure meds?

Since good diet and exercise saves money (which I agree 100%), do you believe the government should allow people to make bad health choices like fast food, smoking, drinking, unprotected sex, risky behavior (skydiving, etc) which drive up the cost of healthcare? How much of a burden to the healthcare industry is from those that are fat, smokers, drinkers?

Type 1 diabetes accounts for 5-10% of all cases of diabetes. Which means the other 90-95% could be prevented by “prevention.” How do you believe that prevention can be enforced?

54. correctnotright spews: The Census Bureau estimates that 45.7 million lacked health insurance at any given time in 2007

Is there a breakdown of those 45.7 million? Like how many are young, how many poor, how many in between jobs, how many in the country illegally, how many unemployed, etc.?

45 million is about 16% of the population. That’s approximately one out of six (I’m a high school dropout so I have to use my fingers and I don’t have that many fingers). In your life, are 1 out of 6 of your friends/family uninsured?

I NEVER said that private healthcare has, it can’t anymore than free government healthcare can. Duh.

See, this is where that personal responsibility thing comes into play.

So how can a government program prevent something without controlling/taxing/forcing it upon us? It’s not as if the health dangers of alcohol were just exposed last wednesday in the obama teev show, it’s been known for decades.

58 – It can and it does. Lots of service man and women coming back from Bushs wars have gotten decent care – prosthetics, counseling, reconstructive surgery what have you but of course a lot of people HAVE NOT resulting in tragedy.

If progressives get their way – that’s going to change and quick.

Business as usual (i.e. the status quo) is not acceptable.

I’m going to point out the government is not able to do everything people need or want.

The government “doing everything” is not on the table. Counter to your right wing fantasies no one is advocating that. Obviously the “free market” has FAILED to do “everything” but that just bounces off your pointy head.

The progressive plan is for a public “option”. Meaning if the status quo steps up, finds a way to lower costs and make a profit while delivering competent care (something they’ve failed to do for years for too many Americans) – then perhaps fewer would want to settle for government health insurance.

In my view it’d be nice to be like other countries where a citizen is automatically covered. And why not like France where even a non-citizen can get care with hardly anything out of pocket? Ever know any touring musicians who needed care in Europe? But we’re America, it takes a while for the blatantly obvious to settle in.

It’s pretty simple… the bigger the pool of insured, the more efficient insurance is. Meaning the cost comes down. Of course the Insurance Industry knows that they can make savings by keeping only those that don’t actually use the insurance. – – – –

@63 The Vets are receiving their care from the government; not buying insurance and choosing their provider – as is being discussed in Congress and here.

Exactly, business as usual. If the government can’t provide healthcare to those it has already promised it, promise it to some more.

then perhaps fewer would want to settle for government health insurance.

Hhmm, pay for your own insurance or get free government healthcare. I don’t see many people giving up something for free, no matter how much better the private sector does it.

And why not like France where even a non-citizen can get care with hardly anything out of pocket?

France heat wave death toll set at 14,802 All those deaths in 104 degree heat. If france was controlling the healthcare in the san fernando valley, the death toll could be millions. And the reason the french parliment blamed on the deaths? (same link)French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly. Chronically insufficient care for the elderly? I wonder if that had anything to do with the increased medical costs of old people.

If only we had unions more like those in france.Health Minister Jean-Francois Mattei has ordered a separate special study this month to look into a possible link with vacation schedules after doctors strongly denied allegations their absence put the elderly in danger. The heat wave hit during the August vacation period, when doctors, hospital staff and many others take leave. The results of that study are expected in November.

And it wasn’t just the socialized medicine in france…Other European countries hit by the heat have been slower than France to come out with death tolls, but it’s clear they also suffered thousands of deaths.

Ever know any touring musicians who needed care in Europe?

Yup, been there myself a few time. I know more musicians from out of the country that have received “free” healthcare.

Hey, every single study says that preventative medicine saves money….do you not pay attention?

Sorry but this is far from the truth.

Preventive pediatric medicine saves a lot of money .. vaccinations, well baby care, nutrition are all great investments because sick kids cost lots of money.

Show me one study that demonstrates preventive care saves net costs in adults.

good diet and exercise plan or years on diabetes/heart/blood pressure meds?

A lot of the rest of your screed on specific issues is mythology. There is a vast difference between demonstrating that a well supervised diet and exercise can improve individual health and showing that money spent these ways decreases costs. Moreover, a lot of the prevention story is far from true or greatly overstated.

@75 Just look at the statistics from say Chicago when they have a heat wave. Lots of deaths.

One thing that drives the numbers up somewhat for Europe is air conditioning is much less common compared to here even in the parts of Europe that regularly see fairly high temperatures all summer long. The older building stock and higher cost of energy has a bit to do with that.

@74 Processed food is generally lower in fiber and nutrition density but higher in sugar, sodium, and fat than whole foods. They also tend to contain trans-fats (though most companies are removing trans-fats from their products now)

Because of the low nutrition density and because most animals crave sugar, salt, and fat people tend to eat more calories in the form of processed food than they should.

This isn’t to say processed foods are “evil” just that one should attempt to limit their intake as much as possible.

The bottom line is that the idea that we have a lot of disease because of eating products made by Kellogs or Proctor and Gamble or even MD’s is way overstated. You can poison yourself perfectly well with a natural diet.

According to factcheck.org – a link Puddy still did not give, I got this:

Foolish NutsTooTight, the link is in #8. Been there for a while. Just like the links for the illegals are in #3.

Butt NutsTooTight loves to puff up his chest and try and look great.

Regarding peer review, while Puddy did find others who peer reviewed it, others disagreed with the peer review. Puddy posted them. If you choose to agree 540 Iraqis or more die per day, so be it.

Regarding this:”All three numbers are likely to be higher for 2008 due to massive job losses.” Then why is “the messiah” and others still using these old numbers FOOL? All Puddy did was use the same numbers argument they did. Whadda moron!

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